Individual
JENNIE MAULDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4112 MAYWOOD DR, BRANDON, FL 33511-7775
(813) 851-7038
Mailing address
4112 MAYWOOD DR, BRANDON, FL 33511-7775
(813) 851-7038
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA45741
FL
Other
Enumeration date
09/08/2008
Last updated
09/08/2008
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